tv Sanjay Gupta MD CNN January 23, 2011 7:30am-8:00am EST
>> i don't know if he is a big enough star. he has a good bod and he can dance. >> he can dance. he is doing pretty well ere. he is still in it. joe carter, thank you. good to see you. most people never see what goes on inside of an operating room. our dr. sanjay gupta is giving us an all action pass. some of this is graphic. hey there. i'm dr. sanjay gupta. today i'm going take you inside after place most people never get to see. at least while they are awake. i'm going give you an all-access pass inside the operating room. have you ever wondered what all those people do inside there? i'm going to tell you person by person. you are going to witness two of the most common orthopedic operations. total knee replacement and an acl repair. when you tear your acl you tara ligament in your knee, fairly common sports injury. today's patient is my good friend, colleague as well,
soledad o'brien. she tore hers. you see her there. she tore hers riding her house. she got a chance to watch her own operation as it was going on. we are going to show you what happened there. we are going to introduce you to an incredible woman whose surgery helped her overcome a traumatic injury after the haiti earthquake. ♪ our first patient is robin gray. she is 54 years old. after decades of wear and tear on her knees her right knee caused her a tremendous amount of pain. >> go to work. it just -- it hurt all the time. >> you can see in her right knee, especially there inside of the medial side, no space left between her femur and particular yeah. >> he's talking about the two bones surrounding the knee.
you see, robin, here rolling in, in the operating room. midtown atlanta. before we get started with the operation, i want give you a tour of what happens inside the operating room. who all these people are. you look at an operating scene like this. the person standing over here usually to the surgeon's right is the scrub nurse. the person who is essentially handing stair aisle instruments to the surgeon. you seeing the dock standing there. he is operating. physician's assistant stands over here. teaching hospital like this, you are going to have a resident, this person over here. the doctor is taking the resident through the case and teaching him, anesthesiologist behind this curtain. responsible for the patient being drifted off to sleep. usually a circulating nurse as well. someone that's not scrubbed but can go get things and hand them off on the sterile table.
you will hear and see what i see when i'm in the operating room. if that sort of thing makes you squeamish you may want to look away for a second. robin is prepped and ready for surgery. let's take a look. >> everybody ready? >> yes, sir. >> there it is. first incision. placing a certain amount of force on that scalpel. getting through the fat layer underneath, the fascia. you may have noticed or may have expected to see more blood. part of the reason you don't is because around robin's leg is a tourniquet. it can try to decrease the blood flow ghost going to her leg during the operation. remember, robin is not experience anything now. she is asleep and not feeling anything. ing the doctor has a lot on his mind. this is the first part of the operation. how everything goes after this, how you visualize these things, three dimensionally, call for all these various instruments, such an important part of this
entire orchestration of surgery like this. let's quickly take a look inside of what the doctor is about to see. this is really very important. a lot of muscle in here. view lot of blood vessels and nerves coming through. this is all very important. when someone is thinking about surgery. you can see how the muscles and the bones all sort of interplay with one another. what is so important is this area in here. it is that arth rritis that's causing so many problems. this is what a bad knee looks like. this is what's causing robin so much pain. once the cartilage is gone, this bone, every time she bends her knee, bone bone, and it hurts a lot. next step really to measure and cut and try to find the best way this implant will fit in here. as they say you want to measure twice and cut once and it has never been more important than it is now. let's listen in.
that sound is the saw. take a look here. this is a very important device. maybe something you have never seen before. it is a metal device that helps guide this praugs. he's using that to help dictate exactly how that saw will work. and how to remove some of the bone, some of the femur. cutting a away the head of the thigh bone. then he will move on to the tibea. the saw can be disturbing if you have never seen anything like that. that sound as well. it is tough to hear. even for people that have done this many, many years. let's take a look at the graphics. when this is all said and done, look at the blue areas, look at what the saw has done, it will look something like this. all that bone that's diseased is gone. this is her native bone, bone she had coming into this operation. sawed off. and perfectly ready now for the implantation. they will put a new near here. precision operated. you only get one shot at making the new knee fit.
>> implants, that's simulating the insert. we measured so far ten millimeter. we will see if this is a good fit for her or not. >> just listen in there. he literally said he's test thing out, ten millimeters. it sounds like trial and error to some extent. it is. that's part of real-life surgery. i want to warn you again that once the knee is in place, this implant is in place, he is going to be testing the fit. it is the most difficult part for a lot of people to see because he is about to put the new knee to the test with a surgical site still open. viewer discretion once again. here we go. >> her knee now goes perfectly straight where it did not before. her stability is perfect. she has no movement on either side. she gets very good flexion here. her kneecap, patella, is tracking perfectly where it
should without me holding it. >> the only thing left to do now is put the implant in place permanently and close up the incision you see there. i got a chance to talk with the doctor shortly after he finished robin's operation and here is what he had to say. thanks for joining us my pleasure. >> how did you like the cameras in there? >> it was great. >> how is robin doing? >> she is doing very well. progressing very nice. >> weeks down the line, is she going to be able to get back to everything she was doing, do more? >> absolutely. back to everything she was doing and hopefully a lot more. >> take a look at soming like th this. is this what's causing the problem? >> yes. >> arthritis, inflammation there causing the pain. >> absolutely. >> we had a glimpse of this in the operating room. this is a model. show us how this works. >> we take the bones and shape the end of the bones. take this implan off -- implant off to show you.
three-dimensional cuts. those are from the front and this is from the side. the implants -- basically replacing the bone we take out. >> how much does an implant like this cost roughly? >> generally somewhere in the $6,000 to $12,000 zblaeng commonly done operation as well. right? how many roughly are done in the country? >> probably around 300,000 a year. >> the numbers are going up. why is that? is this activity? >> it is the population is aging. baby boomers are getting to the age where they need joint replacements. those will be more and more of these done. >> as good as you are, lot of people never want toned don't w your office. >> healthy eating and healthy activities, weight loss, keeping your weight down would improve your risk of not getting this. >> wear and tear on the knees. thanks so much. thanks for joining us. if you want to get more tips on how to avoid ever having a knee operation like that, you can go to our website. we have a lot of information
there. cnn.health.com. soledad o'brien is heading into the operating room as well. you will see it, we will be talking and hearing what it was like. an operation that had a great outcome which he tlits idea of going from tragedy to triumph. this woman was stuck in haiti's quake rubble for five days. now she is overcoming tragedy by sharing her strength with all of us. mary! hey!
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extraordinary things. you are going into surgery and will remove your hand and part of your arm. you don't even know about it. we met one brave woman that found herself in this position because she was trapped for five days in rubble from that earthquake if haiti one year ago. it is a walls disintegrated, as the ceiling crumbled, darlene's first thought was the world is ending. >> translator: dip realize that it was an earthquake. >> reporter: when the earthquake hit haiti she was at work. >> translator: the mirror broke and the glasses and bottles were in the way. kuehne run. thenning the ceiling fell. >> reporter: within seconds she was entombed. pinned beneath a co-worker and a mound of rubble for five days. >> after a while, i felt like i was in a dream. after that, i didn't know anything. >> reporter: she awoke after a three-week coma accord the "u.s.s. comfort." she had no idea what happened to her or her country.
>> translator: i opened my eyes. there were a lot of bright lights and i spoke to someone. i said to him, what happened to me? up until now i didn't know i lost my two hands. >> reporter: without hands she could no longer support her family. >> translator: in my country they shun handicapped people like me. >> reporter: she soon recovered the strength and characterized her before the quake. she decided overcoming her own tragedy could only happen you about sharing her strength. >> translator: my big dream is to help others who have been injured like me. >> reporter: inspired by her, her doctor decided to help. he contacted a state senator in new york who arranged a visa, transportation, and medical care. including prosthetics for darlene. >> extraordinary thing to have gone through what darlene has gone through. instead of curling up inside of yourself to expand your dreams and expand your goal.
>> reporter: while darlene recovers here, her spirit, she says, is already in haiti. >> i have thought why, why me? perhaps it is to help me realize all is not lost. even though i'm handicapped, all is not lost. >> she lost both of her hands. she hasn't lost her hope. she's improving physically and mentally as well. she realizes it could have been a lot worse. she wants to get a degree in psychology now so she can help others that have lost limbs as well. she is a remarkable woman and a real inspiration to all of us. next, getting ready to head into the operating room with our pal, soledad o'brien. >> excited to have the surgery done. start like actually getting better for a final result. i'm really looking forward to it. >> we are, too, soledad. [ male announcer ] 95% of all americans aren't getting enough whole grain. but actually, it's easier than you think, because general mills big g line of cereals
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it is right over here behind the knee. you sort of take this and zoom in a little bit on what the knee looks like. it is usually the ligament that's right behind the patella. you can injure this one, soccer players, football players, runners, sort of land improperly. the knees twist and thatly many can tear. that can cause tremendous pain and swelling. swell sing usually the first thing you have. today we will go back inside of the operating room and see what an acl reconstruction looks like. the doctor will use a small scope and piece of ligament that comes from a cadaver to repair the torn acl. the patient is our own soledad o'brien. she tore her acl, this ligament, when she fell off riding a horse. again, before we get started, you want to warn you that this is real surgery. if you are squeamish, you may want to look away. >> okay. your incisions, a lateral portal, incision side on the tibea will be somewhere based here, and then an incision here.
it is for a tear that she sustained while falling off of a horse. there should be a nice band going from here to here. that's completely black. in this case, you see it is filled with fluid. it is torn through. we are doing a left acl construction. any indicated procedure, soledad o'brien, i agree that it is the left knee. we asked the rest of the staff. >> left knee. >> anesthesia, right. we are ready to go. okay. incision is starting. you can put those away. this is the scope everyone talks about. if you get a look at that, that's all the fluid left in her knee. you get a look at her knee.
she has damage to her kneecap. there is her acl. as you come over here, viewing her acl, you can see that. i will look up there. you can see this is the detached area and it is torn, completely detached off. that's where we will put the graft put the new graft in right over here. we'll start the preparation of the graft and doing a few more minutes of work here on the notch. okay. now, we're going to take the instruments out of the knee and start the graft preparation now. here's the graft board and there's a couple of things on it. we're going to size the graft and here's our graft, okay? it's a tibialies anterioralis and the wire is brought through the knee, right there. now i take the graft.
prepared nicely before, okay. let me get the snaps when you're ready. the graft comes across. two hands always on the graft. the graft. you'll see it actually engage here and up through the knee. you can see there's her new acl. okay. what was it like seeing the inside of the knee? >> it was awesome. i like my new acl. i'm hoping to be able to get off crutches as soon as possible because i'm really tired of being on crutches, and -- and
then get back on my horse as soon as possible. >> i was very pleased with the entire surgery. her, you know, her alograph was excellent. everything was as expected >> you watch that and probably wonder how is she doing now? well, guess what? you get to hear from her. that's next. stay with "sgmd." [ male announcer ] 100 crisps in every can. ♪ 100 ways to enjoy pringles. ♪ ♪ and they're the same price as the leading bag chips. 100 crisps... 100 ways. ♪ everything pops with pringles. you struggle to control your blood sugar.
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. and we're back with "sgmd." before the break, we took you inside the operating room for soledad o'brien's knee operation. it's been three months now since that surgery, and she's recovering well. in fact, i got a chance to check in with her to see just how she's doing. you look great, soledad. good to see you. it's been three months since your operation. >> thank you. feeling well. >> i was going to ask. three months. are you feeling pretty much back to what you were doing before? >> i'm limping a little bit. my knee is definitely bothering me. not 100% at all, but i feel much better.
nice to be off the crutches and cane and walk around and get around on my own esteem, sure. >> it's been three weeks roughly before the time of your injury that you had surgery and you were busy even there and doing big events for a documentary you were doing. what was it like then? were you in a lot of pain? what were you experienceing? >> i was never in any pain except the day after surgery. i heard my ligaments pop and could hear it through my body, pop, pop, pop. it never hurt. never in any pain. didn't take any pain medications except a day or two after surgery. that was good. difficult to lie down, hard to sleep and all of that, but i was never in any kind of raging pain. that's been consistent. once i got through the surgery, same thing. felt pretty good. it aches. feels crampy. it's uncomfortable, but it doesn't really hurt >> i know you -- i think you e-mailed me pretty soon after your injury. i'm not sure if it was right at the time or not. >> for free medical advice. >> which is why i was hired at
cnn, frankly, but were you a good patient? i mean, how quickly did you go see your doctor after that? >> oh, i was a great patient. actually i think that's been highly correlated to how well i've done. i feel like i'm making very good progress. i'm a very good patient. went to see my doctor immediately. went to see the doctor. did the mri, three weeks said i could have surgery, scheduled it pretty quickly and right after that i did physical therapy, even before the surgery and kept up with the physical therapy after the surgery so i think i've been very aggressive about trying to bring myself back. i think for knee surgeries it's all in how much you push yourself and make yourself get to these milestones that you need to hit. my goal is to be able to run. they tell me in a couple of weeks i'll be able to start running, and then hopefully in the spring i should be able to go horseback riding again. >> and i think -- i don't know if this is public, but you've talked about doing a triathlon, a sprint distance triathlon in a few months from now, in june. >> yeah. in june, you know, it's like a
55k and i've run a bunch of 55ks and it's a quarter mile swim. it's not really horribly difficult. i think putting it all together will be hard. i think can i do it. i think my knee will hold up and give me something to aim for in physical therapy because that's the hardest part to want to stick to it and make yourself, you know, do it very aggressively so that's my plan. >> you actually -- you've had a chance to watch the praise. you were awake during surgery. you watched it over i guess a feed, video feed. what was that like to watch your own knee being operated? >> you know, it was weird. it was really weird. i wanted to see it. i was really fascinated. i was pre-med a million years ago and love the medical stuff. especially if it's your own knee. i was on sedation and the doctor kept poking me saying this is important, take a look. it was fascinating. amazing and i've learned a lot about how my knee was put together and also when they were
able to put a new cadaver ligament in. >> right. >> just sort of that, you know, can you grab somebody else's ligaments and, you know, connect it to your own body and i literally wasn't able to walk and now i can walk go really, really well. >> you're going to go back and ride charlotte, right? you think you're getting close to doing that? >> yeah, i'm not bitter that she chucked me. she got spooked and i got ditched so, you know, i will go back. i'm told in april i should be able to go back to riding which is great because by then the snow has melted and becomes nice again. the perfect time of year to start riding, so i'm hopeful that i won't be too anxious getting back on and i'll be able to start riding again. i can't wait. >> good luck, soledad. i'm doing a triathlon in august. maybe we can train together. >> are you? i would love that. >> maybe in new york or atlanta. >> that would be great. >> get to see each other for a little bit. >> yeah, yeah, yeah. i would love that. that would be fun. >> glad you're doing better. great to see you. >> thanks. >> that's what they tell you to do, soledad, get right back up